CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Adventist Health Sonora

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $2,697
Cash Discount Price: $1,372
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Adventist Health Sonora is $2,697. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,372. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 1.22x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.

Cash / Self-Pay

$1,372

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,697

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,214.42

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,214.42 (100%)

Cash / Self-Pay: $1,372 (62%)

Insurance Median: $2,697 (122%)

Cash: $1,372 (62% of Medicare)

Ins. Median: $2,697 (122% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,214.42 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Shield Mcare	$2,132	96%
Central Ca Alliance Mcr Adv Profee Only	$2,132	96%
Healthnet Mcr Adv	$2,132	96%
Tricare	$2,132	96%
UnitedHealthcare	$2,132 - $6,957	96%
Ah Employee Health Plan - All Plans	$2,346	106%
Cigna	$2,623	118%
Greatwest Oa/Pos/Hmo	$2,772	125%
Greatwest Ppo - All Other Plans	$2,772	125%
Western Growers/Pinnacle - All Plans	$2,964	134%
Healthnet - All Other Plans	$3,107	140%
Aetna	$3,160	143%
Blue Shield Epn	$3,218	145%
Blue Shield - All Other Plans	$3,401	154%
Bc Mcs	$3,693	167%
Bc Non-Mcs - All Other Plans	$3,693	167%
Beech Street- All Plans	$7,266	328%
Trpn - Three Rivers Ppo - All Plans	$7,266	328%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,372.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59400.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Sonora is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 59400.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.